An Introduction to EMDR...


So I've finally got round to writing my first blog post of 2017!
I hope your year has got off to a good start...

EMDR is a type of trauma therapy that I have undertaken to allow me to process some of my traumatic memories.
Whenever I mention it to most people, it is usually something they've never heard of and when I explain a bit about what it entails it usually comes across as sounding even more 'weird' than they originally imagined!
The truth is that although I still have a long way to go in the process, this type of trauma therapy has already changed my life in so many ways and definitely for the better!
I hope that by writing this blog post I will provide a resource for those of you who are simply curious to know what EMDR actually means and entails, but also I hope that if you are suffering from trauma, by finding out about my experiences, you will consider EMDR as a possible therapy path to go down .

What is EMDR?
EMDR stands for Eye Movement Desensitisation and Reprocessing.
When you experience a traumatic event, because we are not designed to be able to cope with that level of distress, the memory gets trapped in the part of our brain that is geared up for threat response.  Because of this, whenever reminders come up that are associated with the traumatic memory, the threat system is triggered, which can manifest in the form of flashbacks and feelings of being retraumatised.
All our normal memories that we collect during the day are processed through REM sleep.  EMDR uses induced eye movements to mimic REM sleep, engaging both sides of the brain and causing the traumatic memory to become processed like any other memory, this way the trauma won't feel so current and distressing.




Bilateral stimulation
This is the key element of EMDR - both sides of the brain are stimulated to allow memories to be processed.
In practice, this is usually achieved through eye movements.  In my case, my therapist will ask me to think of an image, thought or feeling associated with the traumatic memory and then move her hand from left to right in quite a fast rhythmic motion which I follow with my eyes.
It isn't a form of hypnotism because you remain present and aware of your surroundings.
 In fact feeling in the present moment is a crucial element of EMDR.
Bilateral stimulation can be achieved in different ways:
I've heard of some therapists using lights and I know that another common way is being tapped on the top of your legs left, right, left, right repeatedly.
I know this all probably sounds quite 'weird' and unusual, especially if EMDR is something you've never come across before.
In all honesty, that was my initial reaction when I was first introduced to it.
However, I think that, like with any therapy, you have to be open to trying anything that could potentially make you feel better and be open to the possibility that it could work.

My first (negative) experience of EMDR
Unfortunately, my first introduction to EMDR was not a good one.
Over 3 years ago, I was referred to a primary care counselling service.
It was basically the standard short term counselling service that GPs refer people to.
In actual fact, it turned out to be a completely inappropriate service to refer me to as my mental health difficulties were far more severe than what the service was designed to be able to deal with, but that's a whole other story...
With hindsight, I can see that I wasn't in a stable and safe enough position at the time to be able to cope with EMDR - I was severely depressed, was experiencing regular suicidal thoughts, high levels of anxiety, panic attacks, frequent dissociative episodes, I had relapsed quite badly back into my eating disorder - throw EMDR into the mix and it was a recipe for disaster.
I also didn't feel fully prepared for what the process would entail - I wasn't fully prepared for the fact that it would involve facing the traumatic memories so intensely and my symptoms could get considerably worse before they got better.
I was basically given a one page information sheet the week before about the process and then the next session it was happening.
Without much warning, I suddenly found myself sat knee to knee facing my therapist and she started tapping my legs.  I did not know this was going to happen and it freaked me out.
I associated my legs, particularly my upper legs, with the trauma, plus I am not very good with physical touch due to trauma related reasons.
I did manage to get this across and so we then tried eye movements.
With EMDR, you generally start off by trying to install positive memories and images of safety, which you can later draw upon when processing the traumatic memories.
I believe this is what we were trying to attempt but somehow a traumatic memory ended up being triggered and following that session I had the worst reliving experience I had ever endured and I was completely unprepared to be able to cope with it.
I can't even explain just how bad the reliving experience was, but I know that it went on for over 12 hours, made me feel paralysed, completely out of touch with time and space, and at times I wasn't sure if I was dead or live.
I decided there and then that EMDR had not worked for me, I felt a bit of a failure and was terrified of trying it again - I had more or less completely ruled EMDR out of the equation.
Needless to say, little did I know at the time, that was not to be the end of my journey with EMDR.
Over 2 years after that point, I found myself in quite a different position...
It felt as though I had been to hell and back to get there, having survived various crisis situations, a nightmare inpatient admission, being signed off work for 7 months...  However, for the first time ever, I decided to start taking medication, which lifted my mood and lowered my anxiety.  As well as this, I had generally pulled myself out of the gutter, made various life changes, had developed a more positive outlook and commitment to my recovery.  I had also successfully undertaken a safety and stabilisation therapy course and had begun long term therapy with a psychologist who even from the outset seemed to understand my difficulties and who I felt I could grow to trust.
It was my psychologist who suggested that I reconsider trying EMDR with her.  At first, I was reluctant, but once she explained why she thought it would be the most suitable approach for me and how we could do it in a way that I would feel prepared and as though I had a say in the process, I was persuaded and I am so glad that I made the decision to try it again.
What I want to get across by sharing this is not to rule out a type of therapy, or therapy in general, based upon one bad experience.
Not all therapists are the same and sometimes it's about the right timing for you rather than the right process.

The importance of safety and stabilisation before processing
If my negative experience of EMDR taught me anything, it was the importance of safety and stabilisation before processing.
I previously wrote a series of blog posts about safety and stabilisation skills that may be of interest:
~ Building a Sense of Safety
~ Stabilisation: Managing Flashbacks
~ Safety and Stabilisation: Breathing and Relaxation Techniques
~ Safety and Stabilisation: Grounding and Staying Present
Basically, safety and stabilisation is about learning skills to better manage your post traumatic symptoms so that you are able to cope with the intensity of the processing phase of therapy.
It can feel slightly frustrating at times in that during the safety and stabilisation phase, you do not actually talk that much about the trauma, even though you might feel as though you want to.
It is more about learning how to manage better what you live with as a result of the trauma.
When you enter the processing phase you will have to put the skills you have learnt into practice more.
It is important to remember that you can always return and revisit safety and stabilisation skills at any point during the therapy.
I actually had to take quite a large break from EMDR to return to working on safety and stabilisation when I started to suffer from dissociative seizures and also had to work on managing my
Dissociative Identity Disorder better in order to be able to navigate EMDR.

The benefits of EMDR above other trauma therapies:
The main benefit that always stood out to me of using EMDR to process trauma memory above other types of therapy is that is involves a lot less talking!
I find that putting things into words can become a bit of a stumbling block, especially when you are trying to talk about something traumatic.
I think that quite often traumatic memories are beyond words - they involve thoughts, feelings, images and bodily sensations.  I feel that EMDR caters for this range of experiences better than talking therapy per se.
That's not to say that EMDR does not involve talking things through at all!
The way it works is that you do a set of eye movements (or tapping) and then you feedback to your therapist what you experienced.
This gives you some control over what you share and choose not to share.
It is possible to process a traumatic memory through EMDR without sharing every gorey detail.
That's not to say either that you are holding information back.
It is about sharing what feels important to share and that allows the process to feel a little more personal.

There is no right or wrong with EMDR
This is really important to remain mindful of throughout the process.
Because EMDR is not something you have ever experienced before and that most people haven't experienced, you sort of have nothing to compare it to.
I can say from personal experience that you get this initial feeling of am I doing this right?
Should more be happening?  Should less be happening?
Should I be feeling or thinking something more than I am now?
The truth is that an important part of the process is to simply just experience whatever comes up for you.
There will be times when you sit there and all you are thinking about is watching your therapist's hand go from side to side, feeling like a bit of a berk because you could swear that something more profound ought to be happening.  That is completely normal too!
The only thing you can do is be open to whatever might come up through EMDR, whether that's a thought, feeling, sensation, image, sound or nothing at all - try not to judge or question it,
just allow yourself to experience it.

What to expect:

A typical EMDR session
I am mainly going off my own experience here but I believe most EMDR sessions follow a similar structure.
Guidelines state that EMDR therapy sessions should be on the longer side -
90 mins is recommended.
It usually starts with a general check in where you just talk with your therapist about what has happened for you during the week.  You may experience a lot of trauma related thoughts, feelings and images as a result of the processing during the previous week and you can discuss what came up for you during the check in.
Before beginning processing a memory, you usually have to fill out a protocol sheet with your therapist in which you explain what thoughts, feelings, images and sensations you get when thinking about the trauma.  You rate your levels of distress and that acts as a really good guide to see whether your level of distress decreases through the process.
Interestingly, I have found filling out the protocol sheet one of the most difficult parts of the process as even just thinking about the trauma in order to answer the questions would cause me a very high level of distress.
Sometimes the only way I could get through it was to see it as a procedure and answer the questions in a very disconnected way just to get it done.  This is okay too as you can start to become more connected to what happened through the process.
Usually your therapist will ask you to bring up a thought or image from the protocol sheet and then will begin a set of EMDR.  The sets are usually quite short, probably less than a minute, but it can feel like a very long time!
In between the sets you discuss with your therapist what came up for you during the sets.
Generally you just follow wherever your mind takes you.
At the end your therapist should make sure you have time to settle down so that you are grounded and in a safe enough state to leave and go home.
How long or how many sessions it takes to fully process the trauma will depend upon how severely the trauma affects you, as well as other factors.  It is probably possible to process some traumatic memories in just one session but I think it is more common for most memories to take at least a few sessions to fully process.  It is most helpful to adopt the attitude that it takes as long as it needs to take.  In general, I have found that most memories have taken longer to process than I originally expected.  This is because often you don't realise just how much there is to a traumatic memory until you start to face it - some parts of the memory may become clearer and you may have repressed, or suppressed certain thoughts and feelings before.

Processing doesn't stop after the session
I would actually say that more processing occurs during the week after than during the session as you have more time to think things through at your own pace.
It is important to remember that EMDR is not just a case of turning up once a week and then everything you cover just get packaged up ready for next time.  Some of it does, a lot of it doesn't, and that's what makes the process so hard and intense (though thoroughly worthwhile in the end ;)

You may feel a lot worse before you feel better
This is the hard bit.
EMDR brings to surface a lot of traumatic memories that you may have tried your whole life to bury.
It is incredibly intense and as a result you can feel an awful lot worse initially, with your trauma related symptoms heightened.
During this time, it is important to utilise your safety and stabilisation techniques, as well as trying your best to trust the process and, in turn, trust that you will feel better than this.

EMDR can make you experience a higher level of tiredness than anyone could prepare you for
Whenever you read a standard information sheet about EMDR, it usually tells you that you may feel quite tired after a session of EMDR.
They usually advise you to consider not driving afterwards - I certainly would advise not to!
However, I don't think you can fully appreciate just how tired it can make you until you experience it.
EMDR is incredibly emotionally draining and can feel physically quite draining as well.
I usually don't feel completely back to my normal self until a couple of days after at least.
It can help to schedule your week to accommodate the tiredness, making sure you fit in a lot of self care to help you recover.

What you can achieve...
I fear I've provided a lot of information about just how intense and hard the process is, but I can honestly say that EMDR is so worthwhile when you consider what you are able to achieve for yourself in the end.
I have found it quite difficult to describe what actually happens during the process of EMDR as I believe it can be quite personal in terms of how it takes shape.
However, to give an idea...
You simply allow yourself to remember the details of the trauma and how it made and makes you feel, although there is very little that is simple about that!  Being able to remember it while also remaining mindful that you are remembering the trauma from a position in the present, allows your brain to process the memory in the way that it does other memories and through this you become gradually more desensitised to it - it doesn't cause you so much distress when you remember it.
Interestingly, when I've begun to feel more desensitised to a memory, I can actually start to feel bored when thinking about it because I have thought about it so much and it no longer bothers me as much - this is a huge contrast to my experiences at the beginning of the process.
After allowing yourself to remember what happened and accept what happened in whatever way you can, you may then start bringing in more positive thoughts and images to replace or lessen the negative ones within the trauma.
This is not an attempt to change what happened, you will always remember what happened for what it was to you and nothing can change that.  Rather it is a way of updating the memory and proving to yourself that things are different now.  You can think about and remember the trauma in a different way and that can feel empowering.  It doesn't have to scare you so much anymore.
I don't really understand how EMDR works.
To some extent, no one is completely sure how it works, but all I can say is that it does!
I have actually felt quite blown away by the results.
So far I have processed two traumatic memories using EMDR and am coming close to completing a third.
Based upon my experiences with the two memories I have processed, I have to say it actually feels incredibly surreal when you are able to look back on the trauma and not experience the huge, often debilitating, levels of distress that it would always trigger in you.
That aspect of it feels overtly liberating - you no longer feel so trapped in trauma.
You can still be left with a degree of distress when you think about the trauma, but in a way, some level of distress in always going to be inevitable.  The main thing is that it is not so distressing that it negatively impacts your life in the present.
I don't think I could ever describe fully just how much EMDR has changed my life, and for the better.
Wrapped up in the trauma were deep-rooted feelings of shame and guilt that hugely shaped my behaviour and the way I preceived myself and the world in the present.  Through the processing of the memories I was able to shatter these largely misplaced feelings, along with it I was able to let go of my sense of over responsibility towards other people - I was able to start living for me more.
What I have found incredible is that many of the things that used to trigger really bad flashbacks in me now don't bother me anymore - in fact, some of them actually make me smile.  I guess you could say that I was able to find some of the beauty in the world again that the trauma had taken away.
I still have quite away to go in the process, with quite a few more traumatic memories left to process, but I try to be mindful of just how far I've already come, and I have every confidence that EMDR can get me to where I need to go.

To be continued...
I plan to write some future blog posts about EMDR and more specific related topics, which may include:
~ The use of EMDR to treat complex trauma ie. multiple traumas
~ How EMDR can be managed if you suffer from dissociation
~ How EMDR can be achieved if you also suffer from Dissociative Identity Disorder
~ I may also share some more of my own experiences of how EMDR has taken shape for me and the processing of my traumatic memories
In any case, I am actually really excited to be writing about a process that has become such an important and transformative part of my life.

I hope that from whatever position you have come to read this blog post, it has been helpful and informative in some way.
I think it's probably very clear that I would strongly recommend EMDR as a trauma therapy.
However, more than anything, I have really enjoyed actually being able to share what I have come to know a fair amount about through my own experience.  Especially as EMDR is such a huge part of my life yet it is something that most people who know me (and people in a wider sense) actually know very little, if anything, about.

(I realise that the relevance of the pages of my scrapbook I have included in this blog post may be a little unclear.  They basically reflect some of the more positive ideas and images I have been able to bring into the memory I am currently processing)


Love and Strength,
The One Day Seeker.

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